Mối liên quan giữa lâm sàng và hình ảnh học của nhồi máu não tái phát do tổn thương động mạch não giữa

Abstract

Objectives: Evaluate the relationship between clinical and imaging of recurrent cerebral infarction dued to MCA damaged. Subjects and method: A cross-sectional, descriptive study of 77 patients with recurrent cerebral infarction dued to damaged middle cerebral artery treated at the Neurological Center, Bach Mai Hospital from July 2021 to August 2022. Results: Motor paralysis of the hemibody on the opposite side of the injury, paralysis of the central VII nerve on the opposite side of the injury and decreased sensation of the hemibody on the opposite side of the injury are symptoms seen at a high rate, accounting for 100% respectively; 90.9% and 77.9%. The proportion of patients with consciousness disorders from the beginning accounted for 49.4% of patients, 2 patients were in a deep coma when hospitalized (accounting for 2.6%). Language disorders including Broca’s language disorder, Wernicke’s language disorder and mixed language disorder accounted for 20/77 patients (26.0%). Horizontal eye and head deviation, circular muscle disorders, loss of attention on one side of the body, and hemianopia account for 32.5% respectively; 26.0%; 22.1%; 26.0%. 7.8% of patients had mental disorders and 14.3% of patients had seizures when hospitalized; The symptoms of headache, nausea, and vomiting accounted for 45.5% and 31.2%, respectively. Patients with symptoms clustered into Gerstman syndrome and Anton - Babinski syndrome account for a low rate: 9.1% and 11.7%. The most damaged arterial branch is the M1 branch with 31 patients, accounting for 40.2%; Oblique branches of the middle cerebral artery or putamen-striatum branches account for 32.5%. Only 4 patients had damage to branches M3 - M4 (accounting for 5.2%). The number of patients with damage to the M1 branch who had consciousness disorders accounted for the highest rate of 33.8%, with no patients with damage to the deep branch having consciousness disorders. Symptoms at hospital admission: consciousness disorders, speech disorders, turning eyes and head to the damaged hemisphere have a statistically significant relationship with the location of the damaged middle cerebral artery branch (p < 0.05)Conclusion: Recurrent cerebral infarction due to damage to the middle cerebral artery has diverse clinical symptoms, depending on the damaged middle cerebral artery branch.